What EKG change is characterized by an ST segment leaning towards the QRS along with a prolonged QT interval?

The description of an ST segment that leans towards the QRS complex, in conjunction with a prolonged QT interval, is indicative of hypercalcemia. In hypercalcemia, elevated calcium levels can lead to specific changes on an electrocardiogram (EKG). The most notable EKG changes associated with hypercalcemia include a shortened QT interval; however, in some cases, it can result in an altered morphology of the ST segment, giving the appearance of the ST segment tilting towards the QRS.

Additionally, a prolonged QT interval suggests a disturbance in the cardiac repolarization process that may occur with electrolyte imbalances, and while hypercalcemia might not be the most classic cause, it is possible under certain conditions, especially if there are concurrent factors affecting myocardial repolarization.

Hyperkalemia and hypokalemia can also lead to distinct EKG changes, typically affecting the T wave and overall QT interval—hyperkalemia often causes peaked T waves and a shorter QT interval, while hypokalemia can lead to flattened T waves and prolongation of the QT interval. A normal EKG reading would not present with any significant abnormalities as described in the question.

Thus, based on the provided characteristics, hypercalcemia aligns most